ABSTRACT
Objective: To explore effect of format change in house job training and other factors, hindering or promoting junior doctors' training/learning in their transition to practical life
Study Design: Mixed Method Sequential
Place and Duration of Study: Sir Ganga Ram hospital Lahore, from Nov 2011 to Oct 2012
Material and Methods: Four hundred and ninety two doctors completed the modified PHEEM survey after completion of their house job from November 2011 till October 2012 after institutional ethical review Board's approval. Second phase comprised semi-structured FGD to triangulate findings of the survey with FGD results, to find out, in detail, about doctors' expectations from their house job training and suggestions for future after ensuring confidentiality and anonymity to study participants
Results: The mean overall score for clinical learning environment was 77.67, implying 57.0 percent satisfaction. Themean total scores for autonomy; teaching and social support was 25.6, 31.9 and 20.0 respectively. Satisfaction with regard to autonomy, teaching and social support was 25.6/48 [53.3 percent], 31.9/52 [61.3 percent] and 20.0/36 [55.5 percent] respectively. Patterns emerged from FGD were lack of standardization, nonexistence of formative assessment, opportunistic learning, poor quality feedback and inappropriate teaching by medical officers. Skill learning under supervision, confidence in patient management and part of clinical team were motivating factors while poor accommodation, sanitation, catering facilities and short duration of rotation were hindering factors for learning
Conclusion: Evidence generated has shown that internship year was very challenging. Dissatisfaction was expressed with unstructured opportunistic nature of training. Unstructured training program, role ambiguity, substandard physical environment and short duration of rotations were perceived to negatively influence learning. A valued member of clinical team, confidence in patient management, opportunity to acquire procedural skills under supervision and being supported were the factors perceived to enhance learning
ABSTRACT
To find out the relationship between recurrent aphthous stomatitis [RAS] with deficiencies of haemoglobin, haematocrit, serum vitamin B12, serum Ferritin and red blood cells [RBC] Folate level. An analytical cross-sectional study. Department of Oral Health Sciences, Shaikh Zayed Federal Postgraduate Medical Complex, Lahore, from February to July 2008. Sixty consecutive subjects with active RAS were taken as the aphthous group; 60 age and gender matched subjects without RAS were as the Non-Aphthous group. Five milliliter blood was taken from both groups to evaluate the levels of serum B12, and RBC Folate through radio immuno assay and serum ferritin with enzyme linked immuno-sorbent assay tests. Complete blood count was carried out to determine the level of haemoglobin and haematocrit in both groups. Proportion of subjects with lower values was compared using 2 text of proportions with significance at p < 0.05. Serum Ferritin [p = 0.001], haematocrit [p < 0.001], RBC Folate [p < 0.001] and serum B12 [p < 0.001] were significantly lower in the RAS group. Combined deficiency state [haemoglobin, serum Ferritin, haematocrit, RBC Folate and serum B12] was identified in 13% [n = 8] RAS patients. Frequency of haematinic deficiencies was high in RAS patients. Serum B12 and RBC Folate were significantly low in aphthous group